Tuesday, 17 December 2013

Guide to childbirth - an open letter to my dearest friends

A couple of my dearest friends are due to give birth in the next few weeks.

A while ago, I wrote this letter to another of my best friends. Maybe you will find it helpful too.

I'm so excited for you. You're about to embark on the most amazing journey. One that will change your life, but will also enhance and enrich it so much.

All this is taken from personal experience and so, because it's personal experience, lots of it might not be relevant to you. But I want to share it with you anyway, because you're about to do the most incredible thing in your life.

If this sounds preachy in any way - it's not intended to be. I just wanted to share what has happened to me because maybe just one or two bits might be helpful to you. Feel free to take from it what you will and I won't be offended if you choose to ignore it all. Every woman is different, every pregnancy is different and certainly, every labour and childbirth is completely different.

So - now that the caveats are out of the way - here is my guide to childbirth - I hope at least some of it is useful or it might help in just preparing you with a positive mindset for the birth of your first child.

1) Relax and be open-minded about all the options. You have no idea how you'll cope and what labour will throw at you. So prepare for all eventualities and be open minded about all the outcomes. My first birthplan said: 'If I ask for pain relief, give me all the drugs you've got.'

2) Believe in your body. Women are built for childbearing. Listen to what your body says and go with the flow. Don't fight it. You may end up making noises you never even knew you could make - but if that's what helps deal with the pain, then do it.

3) When it comes to pushing - it really does feel like you need a poo. With my first, I was so frightened of pooing on the bed that I kept clenching up. It took 20 minutes and midwives questioning why I wasn't pushing before they stated the obvious - 'it's supposed to feel like that'. After that, I relaxed and then he was born. I've read lots of birth stories and watched lots of births on TV (I'm a bit obsessed) and it's the ones where women have fought against what their bodies are trying to do and that's when lots of the problems start.

4) You don't have to give birth lying on your back. Again, listen to your body. I instinctively go on all fours when I give birth. I'm not even sure I could give birth on my back. Having read a bit about giving birth - all fours is actually a very natural position to be in. It's just not that favourable for the medical people to monitor the baby (they can still do it, just not as easily), so that's why they're often not so keen.

5) In early labour - be as active and upright as you can. That way, gravity does most of the legwork and your body doesn't have to work so hard for baby's head to sink down into the birth canal. Sometimes, it can also make things go a bit quicker. It is also helpful if you go overdue. When I have been overdue, I have spent the day on a birth ball (well, an exercise ball) just bouncing up and down or gone for a log walk. I'm sure that these things helped me go into labour because I was probably pushing baby down onto my cervix. Also - before birth, if you are upright or doing stuff on your hands and knees, it helps get baby in the optimum position for giving birth. Lots of long hard labours are because baby is back to back - being on your hands and knees reduces the chance that baby will be back to back because gravity will pull its spine forwards.

6) Have a bath. When you're getting quite a few twinges. Jump in the bath. It will make you do one of two things. You'll either slow up (in which case, the pains will go and your body will wait until it's really, truly ready to go) or you'll go into full blown labour and it will speed things up. Whichever way, it relaxes you and helps you concentrate on your body and taking control of what it's about to do. Water is also a great pain reliever.

7) Dealing with the contractions - can be fairly easy if you get in the right zone. If you get a chance to listen to a hypnobirthing CD or read a hypnobirthing book (or even go on a hypnobirthing course), do it! There is somewhere in your mind, a place you can go to where you can minimise and deal with the pains. Above all - and this is what gets me through - remember that the pain will be over in a maximum of 90 seconds (that's how long the contractions are in full blown labour). Every contraction I get I just think to myself, it'll be over in a minute and I'll get a rest and then that's one less contraction until the baby is out. If the pain does start getting too much and you feel yourself not being able to cope or you start to panic - then get the epidural in straight away. You'll need to ask as soon as you think you'll need it because it can take time to administer - but if your labouring for a long time then it is an absolute godsend. The epidural will give you a chance to rest and the energy to push baby out. Sometimes, that rest will stop you being too knackered to push - which might end up in more intervention like forceps, ventouse or even a c-section. But remember it is possible to do it on your own if you are able to find the right mindset (and are lucky enough to have a quick labour). If my labours had been much longer I would definitely have taken all the drugs I could get.

8) Try to avoid too much early intervention. Because there is something called 'intervention cascade' which means that if you have one 'intervention' you are far more likely to have another. The example being that if they decide to break your waters manually instead of waiting for them to go naturally, you are more likely to require pain relief (because the contractions are more intense) and are then more likely to need help with delivery. The reason they'll give to break your waters is to speed things up - which is fine. As long as you weigh up whether you'd prefer intense pain but a quicker labour or you'd prefer to leave things to go naturally and potentially have a slower build up and longer labour. It's totally up to you. I just get concerned when I watch all those programmes (especially the American ones) that some women don't realise the implications that some of the interventions (which are in my opinion unnecessary) will have on their labours.

9) Cutting the cord and a natural third stage - umm, lots of debate on this. I always ask that the cord is not cut until it stops pulsating as I have read that this ensures all the nutrients from the placenta are passed to the baby. However, there are times, if perhaps baby is in distress, when the cord needs to be cut straight away. Just something to think about maybe? Also - I ask for a natural third stage - why have an injection to speed up delivery of the placenta when it can sometimes be delivered within ten minutes anyway? The reason given for the injection is that it can prevent the placenta being retained and helps ensure the whole placenta comes away in tact - again - lots of pros and cons - you decide.

10) Breastfeeding - is not always as easy as it looks but is so worth it. Not just for the health benefits for you and baby but also for the special bond it gives and it also means you don't have to faff with sterilisers etc. Again - every experience is different and it's not for some - but I would definitely recommend it. And if it’s not quite right, be vociferous in getting someone to help. Ask for someone to check your latch and positioning. And be patient. Learning to breastfeed is like learning to dance with a partner, it takes time to learn how you both work together.
11) When baby is born, get as much skin to skin as you can. It regulates baby’s breathing and temperature and it encourages bonding (and milk production). Babies have an instinct to crawl up mum to find the breast (although if you’ve had pain relief baby might be a bit slower). It’s called biological nurturing and it is truly amazing. This video shows it in action: 

12) Lastly - whatever happens. Don’t feel guilty if it wasn’t how you imagined. Life always throws surprises at you - don’t wish it was another way - embrace the challenge!

OK - I'll stop now. I've been on my soap box quite a lot. I'm quite passionate about this. I think, if I wasn’t so squeamish, I might have trained as a midwife. Anyway - take the bits that are useful and ignore the rest.
Good luck with it all - I'm so excited that you're going to have this experience. The first birth is such a special time. Although the second and third are also pretty good too!

What advice about childbirth would you give your close friends?

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